TY - JOUR
T1 - 2010 Perinatal GBS Prevention Guideline and Resource Utilization
JF - Pediatrics
JO - Pediatrics
SP - 196
LP - 203
DO - 10.1542/peds.2013-1866
VL - 133
IS - 2
AU - Mukhopadhyay, Sagori
AU - Dukhovny, Dmitry
AU - Mao, Wenyang
AU - Eichenwald, Eric C.
AU - Puopolo, Karen M.
Y1 - 2014/02/01
UR - http://pediatrics.aappublications.org/content/133/2/196.abstract
N2 - OBJECTIVES: To quantify differences in early-onset sepsis (EOS) evaluations, evaluation-associated resource utilization, and EOS cases detected, when comparing time periods before and after the implementation of an EOS algorithm based on the Centers for Disease Control and Prevention (CDC) 2010 guidelines for prevention of perinatal Group B Streptococcus (GBS) disease.METHODS: Retrospective cohort study of infants born at ≥36 weeks’ gestation from 2009 to 2012 in a single tertiary care center. One 12-month period during which EOS evaluations were based on the CDC 2002 guideline was compared with a second 12-month period during which EOS evaluations were based on the CDC 2010 guideline. A cost minimization analysis was performed to determine the EOS evaluation-associated costs and resources during each time period.RESULTS: During the study periods, among well-appearing infants ≥36 weeks’ gestation, EOS evaluations for inadequate GBS prophylaxis decreased from 32/1000 to &lt;1/1000 live births; EOS evaluation-associated costs decreased by $6994 per 1000 live births; and EOS evaluation-associated work hours decreased by 29 per 1000 live births. We found no increase in EOS evaluations for other indications, total NICU admissions, frequency of infants evaluated for symptoms before hospital discharge, or incidence of EOS during the 2 study periods.CONCLUSIONS: Implementation of an EOS algorithm based on CDC 2010 GBS guidelines resulted in a 25% decrease in EOS evaluations performed among well-appearing infants ≥36 weeks’ gestation, attributable to decreased evaluation of infants born in the setting of inadequate indicated GBS prophylaxis. This resulted in significant changes in EOS evaluation-associated resource expenditures.Abbreviations:BWH — Brigham and Women’s HospitalCBC — complete blood cellCDC — Centers for Disease Control and PreventionCDC2002 — first time period of the studyCDC2010 — second time period of the studyCMA — cost minimization analysisCOFN — Committee on the Fetus and NewbornEOS — early-onset sepsisGA — gestational ageGBS — Group B StreptococcusIAP — intrapartum antibiotic prophylaxisIQR — interquartile rangeIV — intravenousLB≥36 — live births at ≥36 weeks’ gestationROM — rupture of membranesWBC — white blood cell
ER -